Osakidetza (Basque Country, Spain)

Osakidetza (Servicio Vasco de Salud/Basque Health System) is the public healthcare system of the Basque Country, a region located in the north of Spain. Osakidetza was created by the Health Department of the Basque Government in 1983. All the public hospitals and primary care of the Basque Region are under this organization.

The Basque Health System includes 14 hospitals, more than 100 primary care clinics organised through four different geographical areas, apart from the Mental Health Centres, Emergencies and Basque Transfusions and Human Tissue Centre. More than 30.000 professionals work for Osakidetza, which could be considered the biggest organization of the Basque Country.

Osakidetza has a target population of more than 2 million inhabitants. It is estimated that in 20 years, 26% of the Basque population will be older than 65 years old, so this epidemiological pattern requires the improvement of the management of chronic diseases. In the last 15 years, the prevalence of chronic patients has increased remarkably all over the region, so actions related to the patient empowerment through e-Health tools are considered a big challenge for the region.

Mental Health Services in the Basque Country are based on the community care model which (i) promotes integration and standardization of mental health care services, (ii) gives support and facilitates social integration and normalization of the affected population and (iii) endorses coordination of social and health cares.

Mental health Services consist of three regional networks with 4 psychiatric hospitals (777 beds), two contracted long-term mental hospitals and several mental health centers in close collaboration with Primary Care. Mental Health Services in the Basque Country consist of departments and functions across the three provinces of the Autonomous Basque Community. The portfolio of services offered by the Mental Health Department covers general psychiatry (mild and severe health disorders), child-adolescent psychiatry and specific services such as alcoholism, compulsive gambling and drug addiction. The existing services are oriented to face a wide range of disorders such depression, schizophrenia, panic disorder, psychosis, eating and sleeping disorders and suicidal tendencies.

MasterMind services

cCBT:

The four Spanish organisations participating in MasterMind agreed to adapt existing evidence-based cCBT programs to their local cultural context. For this purpose, a group of healthcare professionals (psychiatrists and psychologists) from these regions with expertise in CBT interventions and on-line therapies directed to other pathologies, have worked together to define the clinical content of the cCBT programme to be implemented. As there is no experience with cCBT, the four organisations had to use a stepped approach starting within a Mental Health Care Unit and since spreading to GPs.

Once the patient has accepted to participate in the intervention, the GP or the GP nurse is in charge of explaining how the online cCBT tools works.

The adapted cCBT programme, a web application developed in HTML5, is called “Supera tu depresión” (Overcome your depression) and consists of eight modules.

ccVC:

The Basque Country will implement collaborative care between GPs and specialists. GPs and specialists will organise regular videoconferences to analyse and discuss complex case management, a non-face-to-face clinical session, within the group of patients receiving cCBT.

The technological solution for ccVC will be Lync Server, an internal communication system that is already in use for many other purposes within the Basque Public Health Service, such as sending messages and administering corporate inbox. The main persons responsible for the management of the patient are the GPs. They will use ccVC when a complex case is identified within the pool of patients treated with cCBT. They will then use ccVC when advice is needed to manage these patients. They will agree a schedule to follow-up these cases via ccVC. Additional teleconferences can be set up outside the schedule whenever the GP finds it necessary. Furthermore, there will be psychiatrists and psychologists who will provide advice and follow-up.

The OSAKIDETZA team members:

Role in projectOverall: MethodologistSpecific role in WPs: support in the design of the scientific protocol and the evaluation process.

Role in projectOverall:Clinical partner of Basque Country team in Spain. We are involved in WP3, WP6 and WP8 in the 2nd wave. We will recruite patients for the clinical trial.
Specific role in WPs: In charge of WP8 Localisation of cCBT to new contexts

Expertise relevant to projectPsychologist PhD.
Senior Researcher in University Hospital of Alava.
Large experience in project and clinical trial with patients with mental disorder.
Professor in University of Basque Country, in neuroscience department.